A patient is very short of breath. Which finding should cause the nurse to be concerned that the shortness of breath might be due to heart failure?

An echocardiogram that reflected increased right ventricular wall thickening

A left ventricular ejection fraction (VEF) of 50%

A B-type natriuretic peptide (BNP) of 300 pg/mL

A serum sodium of 135

Answer and Explanation

The Correct Answer is B

A. An increase in O2 saturation to greater than 90%: An increase in oxygen saturation is typically a positive sign and does not indicate worsening heart failure.

B. The onset of atrial fibrillation: The development of atrial fibrillation in a patient with heart failure is a sign of worsening heart failure, as it indicates increased atrial pressure and the potential for further hemodynamic compromise.

C. Louder S1 and S2 heart sounds: Louder heart sounds do not specifically indicate worsening heart failure. They may vary based on other factors such as body habitus or the position of the patient.

D. A decrease in heart rate to 66 bpm: A heart rate of 66 bpm is within the normal range and does not suggest worsening heart failure.

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Correct Answer is B

Explanation

A. Respiratory acidosis: Respiratory acidosis would present with a low pH (below 7.35) and a high PaCO2 (above 45 mmHg).

B. Respiratory alkalosis: This ABG shows a high pH (7.51), low PaCO2 (32 mmHg), and normal HCO3- (26 mEq/L), indicating respiratory alkalosis, typically due to hyperventilation.

C. Metabolic acidosis: Metabolic acidosis would present with a low pH and low HCO3-, but in this case, the HCO3- is normal.

D. Metabolic alkalosis: Metabolic alkalosis would show a high pH and high HCO3-, but the HCO3- in this ABG is normal.

A. “Your liver cannot manufacture bile." B. "Your pancreas is no longer able to manufacture insulin." C. "Your gall bladder is not contracting properly." D. "A gallstone can prevent bile from flowing into the Intestines."

Correct Answer is D

Explanation

A. "Your liver cannot manufacture bile": The liver can still manufacture bile, but the problem lies in bile flow, not production.

B. "Your pancreas is no longer able to manufacture insulin": This statement refers to diabetes, not cholelithiasis.

C. "Your gall bladder is not contracting properly": While gallbladder dysfunction can cause pain, jaundice specifically occurs due to bile flow obstruction, not just poor contraction.

D. "A gallstone can prevent bile from flowing into the intestines": Gallstones can obstruct the bile ducts, leading to a buildup of bilirubin in the blood, which manifests as jaundice.

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A patient is very short of breath. Which finding should cause the nurse to be concerned that the shortness of breath might be due to heart failure?

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Naxlex Comprehensive Predictor Exams

Interpret the following ABG: PH 7.51 Pa02 88 PaC02 32 Bicarb (HC03-) 26 Sa02 95%

Correct Answer is B

Explanation

A patient with cholelithiasis asks the nurse why he/she is jaundiced. What is the nurse's best answer?

Correct Answer is D

Explanation

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